Treatment with PCSK9 inhibitors reduces atherogenic VLDL remnants in a real-world study

• Verfasst von: Hollstein, Tim [VerfasserIn]
• Verfasst von: März, Winfried [VerfasserIn]
• Titel: Treatment with PCSK9 inhibitors reduces atherogenic VLDL remnants in a real-world study
• Verf.angabe: Tim Hollstein, Anja Vogt, Thomas Grenkowitz, Tatjana Stojakovic, Winfried März, Ulrich Laufs, Bediha Bölükbasi, Elisabeth Steinhagen-Thiessen, Hubert Scharnagl, Ursula Kassner
• E-Jahr: 2019
• Jahr: 23 March 2019
• Umfang: 8 S.
• Fussnoten: Gesehen am 25.06.2020
• Titel Quelle: Enthalten in: Vascular pharmacology
• Ort Quelle: New York, NY : Elsevier, 2002
• Jahr Quelle: 2019
• Band/Heft Quelle: 116(2019), Seite 8-15
• ISSN Quelle: 1879-3649
• DOI: doi:10.1016/j.vph.2019.03.002
• Datenträger: Online-Ressource
• Sprache: eng
• Sach-SW: Alirocumab
• Sach-SW: Evolocumab
• Sach-SW: Lipoproteins
• Sach-SW: PCSK9 inhibitor
• Sach-SW: VLDL remnants
• K10plus-PPN: 169235471X

Abstract

Background - Proprotein convertase subtilisin-kexin type 9 inhibitors (PCSK9-I) reduce low-density lipoprotein (LDL) cholesterol in human studies. Previous studies suggest that PCSK9-I may also affect very-low-density lipoproteins (VLDL). We therefore studied VLDL size and composition in a “real-world” study population with the use of β-quantification. - Subjects and methods - 350 patients (62±11years old, 58% men, 22% with diabetes mellitus) with different concomitant lipid lowering therapies, and in whom PCSK9-I treatment was indicated, received either evolocumab (140mg) or alirocumab (75 or 150mg). The major lipoprotein fractions were separated by β-quantification and lipid and apolipoprotein compositions were determined before and 4weeks after initiation of PCSK9-I treatment. - Results - After 4weeks of PCSK9-I treatment, the ratio of triglycerides to apolipoprotein B in VLDL particles (VLDL-TG/apoB ratio) increased by 40% (p<.0001). VLDL-associated apolipoproteins E, CII, and CIII were reduced by 29.4%, 16.4%, and 12.4%, respectively (all p<.0001). - Conclusion - PCSK9-I treatment increased VLDL size (estimated by an increased VLDL-TG/apoB ratio) and reduced VLDL-associated apolipoproteins in a heterogeneous “real-world” study-population, reflecting a higher clearance of small atherogenic VLDL remnant particles by PCSK9-I. This may potentially lower cardiovascular risk in clinical routine patients beyond low-density cholesterol (LDL-C) reduction.